Provider Demographics
NPI:1083665756
Name:DOMBEK, JOSEPH STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:DOMBEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4085 SW 109TH
Mailing Address - Street 2:STE. 200
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3017
Mailing Address - Country:US
Mailing Address - Phone:503-644-4846
Mailing Address - Fax:503-644-1293
Practice Address - Street 1:4085 SW 109TH
Practice Address - Street 2:STE. 200
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3017
Practice Address - Country:US
Practice Address - Phone:503-644-4846
Practice Address - Fax:503-644-1293
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273328111N00000X
OR3328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor